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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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On Chemo. Having Psychotic Episodes. Dehydration And Seizures. Sounds Like?

My husband is going through chemo . In July he started having psychotic episodes. They usually last around five days and then he will start to get better. The doctors have said it was dehydration the first time it happened. The next time it happened they said it might be seizures so they prescribed him a seizure drug. It has not helped. He is going through an episode right now. He talks to people and sees people that are not here for example. Can the chemo be causing this?
Fri, 3 Jan 2014
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Psychiatrist 's  Response
hello and welcome to HCM!

I have read your question carefully and see that the patient is on chemotherapy, developed some psychotic symptoms on and off, and having one episode right now.

The point that he had it previously, which went away after one week, points to a possibility of delirium- caused due to some electrolyte imbalance ( may be related to chemotherapy ). So, you need to get his electrolytes measured - serum sodium, potassium, calcium, chloride, phosphorus, and kidney function test, blood sugar also.
If these are disturbed, correcting them will certainly help and he will be fine .

When ever we have such a patients, who is on some to the other drug for some porblem & develops a short psychotic episode, I find Haloperidol 0.25-05 mg very effective. I would like to assess such patient twice daily, and then adjust daily dosing .

Almost always, this drug helps to manage even a serious episode.

I can understand your problem, it is very scary to see your near and dear one behaving like this. But I would ask you to please donot feel helpless, it can be managed.

Do not try to give too much of any sleeping pill to him, it might not be good for him.

### Many times these episodes increase as evening and night comes, this points again in favour of delirium.

Hope the reply is useful
Feel free to ask more questions
Dr. Manisha Gopal
MD Psychiatry.

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On Chemo. Having Psychotic Episodes. Dehydration And Seizures. Sounds Like?

hello and welcome to HCM! I have read your question carefully and see that the patient is on chemotherapy, developed some psychotic symptoms on and off, and having one episode right now. The point that he had it previously, which went away after one week, points to a possibility of delirium- caused due to some electrolyte imbalance ( may be related to chemotherapy ). So, you need to get his electrolytes measured - serum sodium, potassium, calcium, chloride, phosphorus, and kidney function test, blood sugar also. If these are disturbed, correcting them will certainly help and he will be fine . When ever we have such a patients, who is on some to the other drug for some porblem & develops a short psychotic episode, I find Haloperidol 0.25-05 mg very effective. I would like to assess such patient twice daily, and then adjust daily dosing . Almost always, this drug helps to manage even a serious episode. I can understand your problem, it is very scary to see your near and dear one behaving like this. But I would ask you to please donot feel helpless, it can be managed. Do not try to give too much of any sleeping pill to him, it might not be good for him. ### Many times these episodes increase as evening and night comes, this points again in favour of delirium. Hope the reply is useful Feel free to ask more questions Dr. Manisha Gopal MD Psychiatry.